DDW-2025-001803

Utah Division of Drinking Water Operator Certification Program DIRECT RESPONSIBLE CHARGE OPERATOR (DRC) APPLICATION
Division of Drinking Water Operator Certification Program P.O. Box 144830 Salt Lake City, Utah 84114-4830 Phone: [phone] E-mail: [e-mail]
Direct Responsible Charge Operators (DRC) are active on-site operators that make decisions that
affect the quality and quantity of the water. To meet the DRC requirements, the operator must gain
the necessary experience, be certified at the system’s classification level, and apply to be a DRC.
Checklist Instructions:
☐Step 1 The Water System must submit a letter on water system letterhead to the Division
requesting to add a new Direct Responsible Charge Operator (DRC).
☐Step 2 The operator must verify if they have the required DRC experience using the chart here:
 https://documents.deq.utah.gov/drinking-water/field-services/DDW-2021-000195.pdf

☐Step 3 The Operator must fill out this application completely and send it to the Division of Drinking Water.
PERSONAL INFORMATION
Distribution Grade level (SS,1,2,3,4): Treatment Grade level (1,2,3,4): Certification #:
First, Middle, & Last Name:
Email: Cell Phone:
Home Address: Home Phone:
City: State: Zip: Work phone:
EDUCATION
What is the highest level of education you have completed?
HIGH SCHOOL DIPLOMA OR EQUIVALENT: ☐
COLLEGE GRADUATE: Degree Major Year
Degree Major Year
WATER SYSTEM & DRC OPERATOR DESIGNATION
Water System Name: System#:
Email: Phone:
Job Title: Are you within one-hour travel time of the Water System: ☐ Yes ☐ No
Start Date: Total years with this employer: Total years of DRC experience:
Description of job duties and experience (required for DRC approval):
EMPLOYMENT & Experience
Water System Name: System#:
Email: Phone:
Job Title: Start Date: End Date:
Total years with this employer: Total years of DRC experience:
Description of job duties and experience (required for DRC approval):
EMPLOYMENT & Experience
Water System Name: System#:
Email: Phone:
Job Title: Start Date: End Date:
Total years with this employer: Total years of DRC experience:
Description of job duties and experience (required for DRC approval):
Duplicate this page until the experience required for a DRC Status is met.
Operator's signature: Date:
" By signing, I certify the above information is correct & complete.
I understand that all info might be verified by Drinking Water staff. "